As the Care Quality Commission (CQC) hits the headlines for failing to properly inspect maternity and children’s services at NHS Morecambe Bay, and for suppressing a critical report, Ruth Cartwright writes…
I find myself thinking back to the launch of the CQC in 2009.
Formed from the Commission for Social Care Inspection, the Healthcare Commission and the Mental Health Act Commission, the CQC was heralded as an agent for “joined up picture of health and social care”.
The launch event was certainly impressive. As we sat in a top London hotel in seats arranged “cabaret-style” equipped with a state-of-the-art electronic voting system, a social worker raised their hand.
Addressing a panel of dignitaries including now-disgraced Chief Executive Cynthia Bower taking part in a Q & A with the audience, I asked “Is part of the agenda in merging the inspectorates to save money?” The answer was, “It is expected there will be efficiencies and this is part of our aims.”
I didn’t think then that that was a good idea and I certainly don’t think so now.
The number of inspectors with an expertise in social care was reduced, only to have to be increased again. Ms Bower resigned in ignominious circumstances in 2012 after increasing criticism that the watchdog was not fit for purpose.
CQC Chair Jo Williams had to resign after casting aspersions on the mental health of non-executive director and whistle-blower, Kay Sheldon and in the last six months five senior directors have left with substantial pay-offs.
James Titcombe, whose son Joshua died as a result of a preventable infection at Furness General Hospital in Morecambe Bay, this week expressed his gratitude to Kay Sheldon, saying that without her actions the damning report would not have been made public.
Cynthia Bower, her deputy Jill Finney and media manager Anna Jefferson have subsequently been implicated in suppressing an internal report on its failure to blow the whistle over deaths at the maternity unit at Furness General Hospital.
The simple truth Kay Sheldon was trying to expose, common in many scandals such as Winterbourne View, is the CQC has not been doing its job.
Managers and directors of CQC must enable inspectors with relevant experience and expertise to go into homes and hospitals to make sure people are being treated properly.
They need to be free to listen to patients, service users and carers, to inspect records, to speak with staff, to observe what is going on, and to question managers. This same freedom must be applied to accurately report findings and in imposing sanctions where needed.
Most importantly, they need to be enabled to take a very cynical view of the services they are inspecting, as they may be the only ones who can speak up for people who are powerless and in desperate situations.
Inspectors do not deserve to work for an organisation which seems to change findings for political reasons and which now says it is not able to do its job properly and needs more resources. The pretence that all was well has let down people in very vulnerable situations.
It is in all our interests that the names of those who suppressed the Morecambe Bay report have been revealed.
This “cover-up culture” must end.
New CQC Chief Executive David Behan and new chair David Prior New Chair) must tackle these failings in the Commission head-on.
David Behan is a social worker and understands social work values. He is in the thick of a media storm, but he has to hold his nerve and inspire public confidence in his leadership.
David Prior has admitted to Radio 4’s Today programme that the CQC’s systems are not currently is set up to properly inspect hospitals, one of their key functions, saying “The fact is we have been in the position for a long time now of giving assurances to the public that we didn't back up by expert inspection. I've known for the past three months we were not fit for purpose when it came to hospital inspections.”
What does this mean for service users in care homes? It means that we as social workers have to be very vigilant indeed on their behalf.
The care in many homes is excellent but there are many areas of concern and these should be reported to CQC straight away.
We may not be able to rely on them to act, but it is our duty to champion the needs of service users.